Core Aspects of Accessibility
3-4 Minute Read
Author: Becky Jayakumar, PharmD, BCIDP, BCPA
Purpose
To describe the continuum of accessibility and the core aspects of accessibility.
Learning Objectives
(1) Describe the continuum of accessibility.
(2) Differentiate the general types of accessibility that affect those with access needs.
(3) Summarize benefits of implementing accessibility and consequences of nonconformance.
As medical educators, it is imperative that we commit to cultivating clinical environments that are inclusive, accessible, equitable, and representative of our local community both for our patients and our learners. To do this, accessibility must be considered in all aspects of the design and development of our spaces and practices. Implementing accessibility measures into the academic work environment can be daunting, but starting small and incorporating best practices is a great way to initiate changes and promote inclusion.
Continuum of Accessibility
We began the conversation about the importance of accessibility in our Disability 101 post, and we continue it here by starting with how to frame accessibility. Accessibility exists on a continuum which starts with inaccessible, moves to accommodations, and ends in accessibility. Obviously, inaccessible experiences and materials exclude individuals from fully participating. Accommodations are typically modifications or adjustments that are made for an individual with a disability on an as-needed basis to give access to that one individual. Often, providing accommodations requires extra work and frequently delays the availability of the access for that person, whereas accessibility – also, referred to as universal or inclusive design - provides equal access for everyone without extra effort since it is built into the processes.(1) Making experiences and materials accessible is a proactive response to the needs of our patients, students, faculty, and staff.
Types of Accessibility
Physical Accessibility
Physical access is the first thing most people think of when they consider accessibility. The Americans with Disability Act (ADA) in 1990 set standards for employers to ensure access to the physical workplace both for employees and the general public.(2) This includes providing access during the job application process, interview, for day-to-day operations essential for job functions, and for the general public’s access to the business. The U.S. Access Board further defines the standards for physical accessibility(3) and our local Southwest ADA Center offers guidance as well as one-on-one assistance to employers.(4) Both the examination rooms and medical equipment should be considered when assessing accessibility in medical care facilities. The Centers for Medicare & Medicaid Services along with the ADA gives more information regarding making medical care accessible.(5,6)
Technological Accessibility
Technology is part of our everyday life and is one of the central drivers of productivity, and lack of technological accessibility is an important driver of inaccessibility for individuals with disabilities. In 1989, universality and non-discrimination were described as core principals of the early web and internet community.(7)
Technology can be directly or indirectly accessible, which means that it is usable without additional assistive technology or is compatible with assistive technology, respectively.(8) Digital accessibility should be considered for all aspects of work including meetings, events, career fairs, trainings, and similar activities. Often, one of the major barriers of digital accessibility are proprietary software or webpages in which accessibility was not considered during development and was implemented by programs without testing accessibility by the end user. In 2010, the Department of Justice announced the development of regulations for website and application accessibility as the ADA requires; however, no movement has been made to set standards or subsequent penalties for accessibility noncompliance. Thus, a bipartisan legislation has been proposed in 2023 to establish, mandate, and enforce minimum accessibility standards.(9) Additionally, the Partnership on Employment & Accessible Technology, which is funded by the U.S. Department of Labor’s office of Disability Employment Policy, offers a range of resources around technology accessibility in the workplace. (10)
Attitudinal Awareness
“Accessibility is not a problem to be solved. It is a culture to be built.”
– Sheri Byrne-Haber
Attitudinal awareness is a component of accessibility in the workplace often not considered. Negative attitudes, stereotypes, and misconceptions about disability hinder inclusion and a sense of belonging. There are many potential attitudinal barriers. A few of the more common ones is believing the person is inferior, pitying or dismissing the person, over-generalization based on the stereotypes of disability, fear of saying or doing the wrong thing, believing the person is getting an unfair advantage, assuming that the disability is affecting their other senses, “hero worshipping” since the person is living independently, or denying hidden, invisible, or non-apparent disabilities. These types of pervasive beliefs and attitudes can affect the day-to-day of the person with an access need and ultimately, their productiveness. Employers can help break down attitudinal barriers by engaging in discussions and providing trainings about disability and accessibility.(11) Additionally, Harvard University’s Project Implicit provides a virtual laboratory to further elucidate implicit bias you may have toward groups of traditionally marginalized individuals.(12)
Accessibility Considerations
It is everyone’s responsibility to foster a culture of accessibility.(13)
Accessibility benefits all individuals as it typically delivers a better user experience.(13)
Many of the things we use daily were designed for individuals with disabilities including the remote control, (typewriter) keyboard, telephone, scanner, dark mode on electronics, text messages, text-to-speech, and word prediction.(14)
Accessibility gives a competitive advantage through improved productivity, ensuring access to a wider candidate pool and audience, developing and advancing talent, expanding customer base(11), reducing expenses, and inspiring innovation through inclusion.(15)
Consequences of non-conformance includes legal issues, reduced usership, and increased cost, rework, and waste.(16)■
References
(1) University of Minnesota Office of Information Technology. Start with the 7 Core Skills. https://accessibility.umn.edu. Accessed October 17, 2023.
(2) Americans with Disabilities Act of 1990, 42 U.S.C. § 12101 et seq. (1990).
(3) U.S. Access Board. Guide to ADA Accessibility Standards. Department of Justice. 2012. Accessed October 18, 2023. https://www.access-board.gov/ada/guides/
(4) Southwest ADA. Useful Resources. Accessed October 18, 2023. http://www.southwestada.org/html/Links/index.html
(5) History or the Web. World Wide Wed Foundation. Accessed October 19, 2023. https://webfoundation.org/about/vision/history-of-the-web/
(6) Centers for Medicare & Medicaid Services. Modernizing Health Care to Improve Physical Accessibility. March 2023. Accessed October 24, 2023. https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/OMH-Modernizing-Health-Care-Physical-Accessibility.pdf
(7) U.S. Department of Justice Civil Rights Division. Access to Medical Care for Individuals with Mobility Disabilities. June 26, 2020. Accessed October 24, 2023. https://www.ada.gov/resources/medical-care-mobility/
(8) Technological Accessibility. Employer Assistance and Resource Network on Disability Inclusion. Accessed October 18, 2023. https://askearn.org/page/technological-accessibility
(9) Websites and Software Applications Accessibility Act of 2023. S.2983/H.R. 5813. 118th Congress (2023 – 2024).
(10) Digital Accessibility Toolkits. Partnership on Employment and Accessible Technology. Accessed October 18, 2023. https://www.peatworks.org/digital-accessibility-toolkits/
(11) Attitudinal Awareness. Employer Assistance and Resource Network on Disability Inclusion. Accessed October 18, 2023. https://askearn.org/page/attitudinal-awareness
(12) Project Implicit. Harvard University. Accessed October 18, 2023. https://implicit.harvard.edu/implicit/help.html
(13) Creating an Accessible and Welcoming Workplace. Employer Assistance and Resource Network on Disability Inclusion. Accessed October 18, 2023. https://askearn.org/page/creating-an-accessible-and-welcoming-workplace
(14) Martinex C. Accessibility for All: Why Removing Barriers Benefits Us All. October 15, 2021. Accessed October 19, 2023. https://www.inclusivecitymaker.com/accessibility-for-all-removing-barriers-benefits-us-all/
(15) General Services Administration. Benefits of Accessible Design. Section 508. Accessed October 18, 2023. https://www.section508.gov/blog/benefits-accessible-design/
(16) General Services Administration. Practical Reasons for Digital Accessibility: The benefits of digital accessibility and the risks and drawbacks of inaccessible content. Section 508. April 2022. Accessed October 18, 2023. https://www.section508.gov/manage/benefits-of-accessibility/